Agent Code Registration VARTIKA INDIA SERVICES PRIVATE LIMITED Reg.Office:-C/O Rahul Kaushik,Papin Gali, Buddha Colony,B.C Road, Patna, BIHAR-800001 Website:www.vartikaindia.in CIN No.:U69200BR2025PTC073875 Email: support@vartikaindia.in Contact No.: 06224-359039 ADVISOR JOINING PERSONAL DETAILS Name: Father's/Husband's Name: Gender: Male Female Date Of Birth: Marital Status: Married Unmarried Divorced Nationality: Indian Other Occupation: Salaried Self-Employed Student Annual Income: Religion: HINDU SIKH CHRISTIAN MUSLIM Category: GENERAL EWS OBC SC/ST Higher Education: Doctorate Post Graduate Graduate Intermediate Matric Mobile No.: Email: PAN No.: Aadhar No.: Present Address: Same as Present Address Permanent Address: Bank Account Details: Account numbers do not match! NOMINEE DETAILS Nominee Name: Date Of Birth: Nominee Relationship: Upload Photo: Upload Signature: REFERRAL DETAILS SM Code (If applicable): SM Name (If applicable): TM Code (If applicable): TM Name (If applicable): RM Code (If applicable): RM Name(If applicable): Payment Information Total Payment: Coupon Code: Discount Applied! Final Amount: I accept all Terms & Conditions Submit & Pay
